No insurance carriers on this filing. Self-funded welfare plans typically pay TPAs and PBMs through Schedule C, not Schedule A.
No brokers reported on this filing.
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COLLINS BUILDING SERVICES, INC. EIN 51-0312606 NONE | Other services; Direct payment from the plan Service code 49 | — | $287K |
| WARRINGTON, TIMOTHY EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $283K |
| WEBB, WENDY EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $203K |
| MARS, DOROTA A EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $202K |
| MELTON, DAVID EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $191K |
| CLARITY TESTING SERVICES, INC. EIN 13-3869722 NONE | Other services; Direct payment from the plan Service code 49 | — | $173K |
| RODRIGUEZ, APRIL EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $152K |
| AUGUSTYNOWICZ, PAWEL EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $149K |
| HOLMBERG,ERICA EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $140K |
| FLOREZ, RUBEN D EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $136K |
| FOWLER, JAMAL S EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $135K |
| CULPEPPER, CHRISTINE EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $134K |
| CZAJKOWSKI, ROBERT M EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $131K |
| ROSERO, CAROLINA EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $129K |
| STRACHAN, MESHACH EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $127K |
| GHIETTI, ALEJANDRO H EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $127K |
| SAMANIEGO, DARWIN F EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $123K |
| COLON, MARIBEL EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $123K |
| WILSON, DELROY R EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $103K |
| CORDOVA, MARIA H EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $100K |
| ALLIED SYSTEM INTEGRATORS, INC EIN 11-3622037 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Direct payment from the plan Service code 15 | — | $97K |
| GALAZKA, ZYGMUNT EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $90K |
| RESTREPO, MONICA EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $82K |
| COSTA, LEONARDO EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $82K |
| MORALES, YASMIN EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $75K |
| BAZYLCZYK-BIELUCH, ANNA EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $73K |
| CHROSTOWSKI, EMILIA EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $70K |
| CHANLATTE, MASSIEL EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $63K |
| TULLY, PAUL F EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $58K |
| CORONA, MARIA M EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $56K |
| SUAREZ, NILDA EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $53K |
| SCHULTHEIS & PANETTIERI LLP EIN 13-1577780 AUDITOR | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $50K |
| TAVERAS, BRIAN EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $48K |
| PROSKAUER ROSE LLP EIN 13-1840454 ATTORNEY | Legal; Direct payment from the plan Service code 29 | — | $44K |
| AINSWORTH, INC. EIN 83-1674559 NONE | Other services; Direct payment from the plan Service code 49 | — | $31K |
| HICKS, PAUL E EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $30K |
| FORBES, ISAIAH I EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $29K |
| SILVA, ROSA E EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $29K |
| ARISTILDE, DAVE EIN 13-3458660 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $29K |
| DASNEY, ESTHER EIN 13-3458660 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $28K |
| STATE STREET GLOBAL ADVISORS EIN 81-4017137 NONE | Custodial (other than securities); Investment management fees paid directly by plan; Investment management fees paid indirectly by plan; Custodial (securities) Service code 18 | — | $25K |
| NYC TRANSIT SERVICES EIN 11-6002815 NONE | Other services; Direct payment from the plan Service code 49 | — | $21K |
| GALLAGHER FIDUCIARY ADVISORS, LLC EIN 36-4291971 NONE | Direct payment from the plan; Investment advisory (plan) Service code 27 | — | $20K |
| PAYCHEX EIN 47-0900851 NONE | Direct payment from the plan; Other services Service code 49 | — | $17K |
| HEALTHCOR CORPORATE MEDICAL SERVICE EIN 11-3130518 NONE | Direct payment from the plan; Other services Service code 49 | — | $16K |
| INTERNATIONAL SCHOLARSHIP & TUITION EIN 62-1247492 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $13K |
| CITIBANK NONE | Direct payment from the plan; Other services Service code 49 | PO BOX 6201 SIOUX FALLS, SD 57117 | $8K |
| BRISCOE PROTECTIVE, LLC EIN 11-2485383 NONE | Direct payment from the plan; Other services Service code 49 | — | $8K |
| SCHINDLER ELEVATOR CORPORATION EIN 34-1270056 NONE | Direct payment from the plan; Other services Service code 49 | — | $7K |
| ATLANTIC TOMORROWS OFFICE EIN 13-1947545 NONE | Direct payment from the plan; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | — | $6K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 9,376 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 9,376 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
No prospect flags tripped on this filing.